Abstract

(1) Background: a review of the literature found a lack of standardized pediatric guidelines regarding wound management after cardiac surgery. (2) Objective: the aim of the study is to investigate the cardiac surgical wound management in Italian pediatric cardiac intensive care units. (3) Methods: we sent an online questionnaire to the 13 Italian pediatric cardiac intensive care units. (4) Results: ten pediatric cardiac intensive care units (77%) have a protocol for the management of the cardiac surgical wound. The staff members that mainly have the responsibility for the wound management after cardiac surgery are registered nurses and physicians together both in the pediatric cardiac intensive care units (69%), and when a patient is transferred to another ward (62%). Thirty-eight percent of the pediatric cardiac intensive care units have a protocol used to monitor wound infection, and the staff mostly uses a written shift report (54%) to monitor the infection. (5) Discussion: this is the first survey to investigate the management of the wound after cardiac surgery in Italian pediatric cardiac intensive care units. The small sample size and the fact that the centers involved are only Italian cardiac intensive care units are the limits of this study. (6) Conclusions: in the Italian pediatric cardiac intensive care units it emerged that there is a diversity in the treatments adopted and a lack of specific protocols in the management of the pediatric cardiac surgical wound.

Highlights

  • Surgical Site Infections (SSIs) are a possible serious complication after cardiac surgery and are associated with increased morbidity and mortality [1,2]

  • Two centers out of thirteen did not respond to this specific question, and one CICU shared the number of cases for the adult and pediatric population together

  • The organizational structure is different in each CICU regarding the type of patients they accept, organizational structure is different in each CICU regarding the type of patients they neonatal and pediatric, or neonatal, pediatric and adult, and the number of beds allocated accept, neonatal and pediatric, or neonatal, pediatric and adult, and the number of beds for pediatric cases undergoing cardiac surgery

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Summary

Introduction

Surgical Site Infections (SSIs) are a possible serious complication after cardiac surgery and are associated with increased morbidity (antibiotic use, a second surgery, prolonged hospitalization, prolonged periods of mechanical ventilation, inotropic support) and mortality [1,2]. From the literature it has emerged that a consistent number of studies sustained the bundle approach as a valid instrument for reducing the instances of SSIs [2,6,8,9]. Another four studies supported pediatric preventive guidelines and practice bundles as effectual for preventing SSIs [5,10,11,12].

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